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Medical Author:

Charles Patrick Davis, MD, PhD

Charles Patrick Davis, MD, PhD

Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

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Medical Editor:

Jerry R. Balentine, DO, FACEP

Jerry R. Balentine, DO, FACEP

Dr. Balentine received his undergraduate degree from McDaniel College in Westminster, Maryland. He attended medical school at the Philadelphia College of Osteopathic Medicine graduating in1983. He completed his internship at St. Joseph's Hospital in Philadelphia and his Emergency Medicine residency at Lincoln Medical and Mental Health Center in the Bronx, where he served as chief resident.

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There is no specific antitoxin available for ciguatera toxin.

• Some investigators have suggested vomiting should be induced if the victim is awake and alert and has eaten ciguatera toxin-containing fish within the last 3 to 4 hours. Ipecac, a substance that causes vomiting, was suggested as the medication to use, but many investigators now think ipecac causes too much dehydration. Currently some physicians recommend gastrointestinal decontamination with activated charcoal. Activated charcoal may absorb the toxin if done 3 to 4 hours after ingestion.
• Maintain hydration. Intravenous fluids may be necessary for uncontrollable nausea and vomiting.
• No specific antidote is available.
• Osmotic diuretics have been used to decrease symptoms (for example, mannitol [Osmitrol]).
• Amitriptyline (Elavil, Endep) and gabapentin (Neurontin, Gralise, Horizant) may help reduce neural pain symptoms
• Diphenhydramine (Benadryl) and hydroxyzine (Atarax, Vistaril) may help relieve itching.
• NSAID's and acetaminophen (Tylenol and others) may reduce pain
• Avoid alcohol, fish, nuts, and nut oils after exposure to ciguatera toxin because they may trigger recurrent symptoms.

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